Provider Demographics
NPI:1457723967
Name:BURKE, MORIAH JEAN (SBD)
Entity type:Individual
Prefix:MRS
First Name:MORIAH
Middle Name:JEAN
Last Name:BURKE
Suffix:
Gender:F
Credentials:SBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-8142
Mailing Address - Country:US
Mailing Address - Phone:214-607-2166
Mailing Address - Fax:
Practice Address - Street 1:1418 TANGLEWOOD LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-8142
Practice Address - Country:US
Practice Address - Phone:214-607-2166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula